How to request a hospital charge estimate
The Miami Medical Center believes it is important for our patients to understand their potential financial liability before services are performed. Patients are encouraged to request a charge estimate for any hospital procedure/service/test by calling our Business Office at 786-646-4340 or requesting it in person on campus. Estimates are based on information provided by you (the patient) and do not include additional tests/procedures/services ordered by your physician after the initial estimate.
Insured patients: How do I request an estimate of my out of pocket costs?
Every insurance plan is different; we encourage our insured patients to contact our Business Office at 786-646-4340 to request an estimate for services. The financial counselor will ask you to provide the following information:
- Name of insurance company
- Type of policy (HMO, PPO, POS, Indemnity)
- Policy holder/member name
- Policy number
- Group name and number
- Insurance company phone number
- Name of test/procedure/service to be performed
- Discuss financial assistance options that may be available to help cover your cost after insurance payment.
For more information on managed care and billing process, please contact the Business Office at 786-646-4340
International patients, please click here.
Uninsured patients: How do I request an estimate of my out of pocket costs?
The Miami Medical Center provides a discount to patients who are uninsured. We encourage our uninsured patients to contact our Business Office at 786-646-4340 to request an estimate of the discounted amount. The financial counselor will ask you to provide the following information in order to receive the most accurate estimate of the discounted amount.
- Name of test/procedure/service to be performed
- Payment must be made prior to the date of service.
How do I request a complete chargemaster review?
You may request a complete listing of all charges contained within The Miami Medical Center’s chargemaster in person at our Business Office located on campus.
The Affordable Care Act contains a provision that is consistent with our effort to improve the transparency of hospital charges. As a result of the Affordable Care Act, section 2718(e) of the Public Health Service Act requires that every hospital operating within the United States develop a policy to make public a list of the hospital’s standard charges for items and services provided by the hospital.
Understanding your physician billing process
Professional fees, charged by physicians for services provided to you, will be billed by these physicians separately from the fees charged by the hospital. Some physicians may be considered out of network by your insurance carrier. You will need to work with your insurance carrier to address this issue.
Physicians who will bill you separately and may be out of network include, but are not limited to:
- Primary Care Physicians
- Specialty Care Physicians
Our Business Office will bill your insurance carrier(s) directly; who will then provide you with an “explanation of benefits” (EOB) statement. This is not a bill. The EOB itemizes all services you received at The Miami Medical Center and explains what the insurance carrier will pay our hospital and which portion you will need to cover.
Once the EOB is processed, we will bill you for the portion not covered by your insurance and paid as part of your pre-service estimate. This will be due upon receipt. Please note that you may receive separate bills from other providers, including the radiologist, surgeon or anesthesiologist.
We understand the importance of financial transparency and will help you understand all costs associated with your procedure. On or before the day of treatment, you will cover any co-pay or deductible that your insurance carrier requires. Those without insurance will need to cover their charges in advance. The Miami Medical Center accepts cash, cashier’s checks, major credit cards and personal checks with a valid ID.
The Miami Medical Center has a number of ways in which we may be able to assist you in lowering your cost share responsibility while staying compliant with your insurance policy, State and Federal law. To help you plan for your cost-share responsibility, we will provide you with a good faith estimate of your anticipated charges prior to surgery if you contact our business office and request an estimate. The estimate will only reflect charges for the surgery center as the surgeons, anesthesiologists, and if applicable, the pathologist and laboratory, bill separately for their services. Please contact our business office at (786) 646-4340 for further information.
Collection Process, Financial Assistance, Charity Care, and Payment Plans:
- Patients are responsible to pay their co-pay, co-insurance, and self-pay responsibility on the day of surgery. If you have insurance, the surgery center will file a claim with your insurance company and send you a statement detailing the services provided. Any outstanding balance after your insurance has paid is your responsibility. If you have questions regarding why your insurance company did not pay your bill in full, please contact your insurance carrier for further information regarding your out-of-pocket expense. For your convenience, the surgery center has listed all the contracted insurance companies on our website along with the insurance companies web address.
Insurance Contracts and Payment Plans
The Miami Medical Center is currently contracted with Aetna, AvMed (including AvMed Medicare Select) , Blue Cross Blue Shield of Florida, CarePlus, CIGNA, Clover Health, HealthSpring, HealthSun, Humana, United Healthcare, United Healthcare Neighborhood and Workers’ Compensation.
Internationally, we accept health plans from Aetna International, Bupa (GeoBlue), BMI, Best Doctors, CorVel International, Global Excel, GMMI, Guardian Life of the Caribbean, Quality Health Management, RedBridge, Sanus, SunMed, and Vumi. Please click on each provider’s link to access their web pages.
If you are unable to pay on the day of surgery with either cash or a check, the surgery center also accepts Visa, MasterCard, American Express and Discover. We can also offer you a short term payment plan, please contact our business office at (786) 646-4340 for further information. Our Patient Representatives are available Monday through Friday, 8 a.m. – 5 p.m.